Compassion’s Secret Costs

February 2018

WESTERN NORTH CAROLINA

Exactly two months after Mission Health and Blue Cross Blue Shield of North Carolina allowed their contract to expire, the parties have reached an agreement. The decision landed Mission’s six hospitals and 500 practitioners out-of-network for 260,000 people in 18 counties. The statement apologized for stress caused to persons who, during the outage, chose to pay more for medical care, forsake trusted professionals, and drive long distances for in-network care, or allow conditions to worsen untreated. But Mission spokespersons said the cost was justified for raising awareness and continuing the hospital’s viability. Mission had claimed Blue Cross did not offer it enough reimbursement to keep up with rising costs of pharmaceuticals, new technology, and recruiting and retaining top talent. Blue Cross rebutted that it had offered Mission the same arrangement accepted by 40 other hospital systems in the state. Mission has long maintained it engages in far more indigent care than other hospital systems, and analysts have claimed the rift boiled down to determining how much the insurance company was willing to cover cost-recovery markups for paying customers. Details of the new contract have not been made public; the merits of either side’s claims are deemed unsearchable in light of the number of patients treated and the arbitrary nature of coding, billing, and reimbursing visits, as well as the fluidity of policy that characterizes the current state of healthcare in the United States.